Obiectlwei To determine if a clinic system to assess and vaccinate preschool-age children at every clinic visit can improve vaccination rates.

Design

A nonequivalent control group design contrasting an intervention clinic with a comparison clinic.

Setting

Two urhan St Paul, Minn, clinics.

The intervention clinic is a family practice residency clinic, and the comparison clinic is a community health center clinic.

Patients

Primarily a low socioeconomic status white population.

Interventions

A clinic-wide system to identify and vaccinate children at all clinic visits.

Appointment personnel, medical assistants, and physicians all had roles in the intervention protocol.

Main Outcome Measures

Percentage of children at the 2 clinics who were up-to-date for a primary vaccine series at age 24 months and also at the end of the study collection periods, preintervention and postintervention.

Results

The intervention clinic improved the percentage of children up-to-date for a primary vaccine series at age 24 months from 42% to 56% (P=02), while the percentage at the comparison clinic did not change significantly (P=81).

Similarly, the intervention clinic improved the percentage of children up-to-date for age at the end of the study periods from 49% preintervention to 63% postintervention (P=02), while the percentage at the comparison clinic did not improve significantly (P=45).

The system was especially useful for children with few visits to the intervention clinic. (...)